Individual provider Active NPI

Gabrielle Pucciarelli, OTR/L

  • Occupational Therapist
  • Staten Island, NY
National Provider Identifier
1679055875
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
022683 Issued in NY
Practice address
445 Forest Ave
Staten Island, NY 10301-2638
Phone
(718) 979-5678
NPI assigned
Sep 4, 2018
Last updated
Sep 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 022683 NY Primary

Addresses

Primary practice location

445 Forest Ave
Staten Island, NY 10301-2638

Mailing address

74 Tanglewood Dr
Staten Island, NY 10308-1852
Phone (347) 756-0889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
022683NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Sensory Studio SLP OT PLLC PastSince Apr 1, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1679055875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 TANGLEWOOD DR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081852",
            "telephone_number": "347-756-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012638",
            "telephone_number": "718-979-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCIARELLI",
        "first_name": "GABRIELLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.